The Pattern of Valvular Heart Diseases in India During Pregnancy and Its Outcomes

The incidence of rheumatic heart disease is very high in India. The data on the pattern of valvular heart diseases during pregnancy and its outcomes is very scarce. Again, the data in the Indian scenario, the differences in outcomes between different grades of valvular heart diseases and its impact on pregnancy outcomes is very less. We planned to study the different patterns of valvular heart diseases during pregnancy and their outcomes with respect to cardiac complication and perinatal outcomes.

It was a hospital-based prospective observational study. We recruited 71 patients after taking written informed consent. All patients were with term gestation and valvular heart diseases. We did 2D echocardiography to analyze the valve lesion and assess the valve lesion with its maternal and perinatal outcomes.

The mean age of participants in the study was 27 + 5.2 years. A total of 54 patients (76.1%) were less than 30 years and 17 (23.9%) were more than 30 years of age. Six patients (8.5%) presented with New York Heart Association (NYHA) class I, 39 patients (54.9%) presented with NYHA class II, 25 patients (35.2%) presented with NYHA class III and one patient (1.4%) presented with NYHA class IV. The most common etiology of valvular heart diseases was found to be rheumatic in 62 patients (87.3%). The most common valve involved was the mitral valve (69%). New-onset atrial fibrillation (AF) was reported in 26.8% patients and pulmonary edema developed in 15.5% patients. Live birth was observed in 66 patients (93%) compared to stillbirth reported in five patients (7%).

No significant difference in maternal and perinatal outcomes between moderate and severe grades of different valvular heart diseases.